Drug-related deaths among middle-aged white men increased more than 25-fold between 1980 and 2014, with the bulk of that spike occurring since the mid-1990s when addictive prescription opioids became broadly available, according to new 兔子先生传媒文化作品 research.
The study, , also found that, contrary to widely reported research findings, suicide and alcohol-related deaths are not to blame for increasing mortality rates among middle-aged whites.
The results call into question recent reports suggesting that what have become known collectively as 鈥渄espair deaths鈥濃�攂y suicide, alcohol and drugs鈥攁re on the rise among white Americans, particularly men, facing a lack of economic opportunity and an increase in chronic pain.
鈥淲e find little empirical support for the pain-and distress-based explanations for rising mortality in the U.S. white population,鈥� said lead author Ryan Masters, an assistant professor of sociology at CU鈥檚 . 鈥淚nstead, recent mortality increases have likely been shaped by the U.S. opiate epidemic.鈥�
Masters said metabolic diseases, including heart disease, obesity and diabetes, are also playing a key role. After years of declining death rates for such diseases, thanks to new drugs and procedures, that progress has slowed for men and stalled for women, the study found.
鈥淲hen it comes to mortality, we are just starting to see the real health consequences of the obesity epidemic,鈥� he said.
Masters, along with graduate students Andrea Tilstra and Daniel Simon, launched the study in spring听2016 after papers revealed, following years of decline, U.S. mortality rates had begun to inch up among middle-aged white non-Hispanic men and women. Follow-up studies suggested such increases were disproportionately driven by chronic liver disease, suicide and overdoses, which some suggested were 鈥渟ymptoms of the same underlying epidemic鈥� of emotional distress, economic insecurities and chronic pain. One study published in 2015 in the Proceedings of the National Academy of Science referred to 鈥渄espair deaths鈥� among a 鈥渓ost generation whose future is less bright than those who preceded them.鈥�
鈥淭he despair death narrative caught fire and has since begun to inform mortality research and media coverage, and shape dialogue among policymakers and politicians. Yet our research shows it is demonstrably incorrect,鈥� Masters says.
For the new study, he looked at U.S. mortality data from the National Center for Health Statistics, the Centers for Disease Control and Prevention, and U.S. Census Bureau for U.S. non-Hispanic white men and women age 25 to 34 and 35 to 54 from 1980 to 2014. While previous research had lumped men and women, 10-year age spans, and drug, alcohol and suicide deaths together, Masters and his team disentangled the datasets, looking independently at genders, individual year ages and distinct causes of death. They also distinguished between 鈥減eriod effects鈥� in which shifts in mortality rates were similar among all age groups, and 鈥渃ohort effects鈥� in which the shifts were unique to individuals born in a particular time frame.
Assistant Professor Ryan Masters
One glaring pattern emerged. Among men and women of all age cohorts studied, drug-related deaths have skyrocketed.
For instance, in 1980, 1.4 per 100,000 men and 1.76 per 100,000 women died from drug overdoses. By 1998, those numbers had climbed to 9.5 for men and 3.6 for women. By 2014, they鈥檇 risen to 36.5 for men and 24.4 for women.
Meanwhile, the researchers found 鈥渘o substantive increases in white men鈥檚 alcohol-related mortality at any time.鈥� 听Suicide rates did rise slightly between 1999 and 2014 for men and women. But this was due largely to spikes among all age groups during times of economic downturn.
鈥淭his suggests that economic insecurities are not isolated to a single 鈥榣ost generation,鈥欌�� said Tilstra.
With drug-related mortality rates, 鈥淚t took off around the time when prescription opioids became readily available, and it has kept rising steadily ever since,鈥� Masters says.
The team, in yet-to-be published research, has also looked at the numbers for black men and black women and has seen similar patterns of soaring rates of drug abuse across age cohorts since the late 1990s.
鈥淲e do not doubt that times of economic insecurity can have severe consequences for a population鈥檚 health, nor do we doubt that pain and distress can pose serious health problems,鈥� the authors conclude. 鈥淗owever, taken together, our findings suggest that it is unlikely that recent trends in U.S. white men鈥檚 and women鈥檚 mortality rates have been driven by an epidemic of pain and rising distress.鈥�
Instead, the authors point to over-prescription and misuse of opioid-based painkillers, heroin use, and an 鈥渙besogenic鈥� environment. They hope their paper will encourage policymakers and researchers to explore those drivers and their solutions further.
